Now and then, poetic justice breaks through the walls of oppression. For more than a decade, a scandalously negligent psychiatric hospital had crammed poor, disabled clients into shamefully overloaded wards in pursuit of higher profits. Today those once crowded wards are utterly empty. The sounds of silence echo in the deserted corridors of a hospital that will never again slam patients down on its hard floors, strap them in four-point restraints, over-medicate and neglect them as the merciless hours tick away. For at East Bay Hospital in Richmond, the clocks have stopped.
The moment of reckoning came on July 15, 1997, when the doors closed forever on a facility that had a deplorable record of medical neglect, patients’ rights violations, and the cruel over-use of restraints on its poor, disabled and homeless clients. A 15-month campaign by Street Spirit and patients’ rights advocates brought down a very powerful institution, the largest psychiatric hospital in Contra Costa County, with 100 staff and $6 million in annual income earned by profiteering off low-income Medi-Cal patients sent there by counties who failed to monitor the grievous conditions their poorest residents endured at East Bay.
When I called the hospital on July 15, I heard the recorded message: “Thank you for calling East Bay Hospital. We regret to inform you that the hospital is closed.”
An intense feeling flashed through my entire being: “This was for you, Marc Kiefer, to avenge your suffering.” This one was personal. All I could think at that moment was that Marc hadn’t died in vain. His family had suffered a loss so immense, so heartbreaking, that none of us could ever heal that wound. But we could shut down this abusive hospital in honor of his memory and his life. We could close its doors forever so that no one else ever suffers that level of callous neglect and shocking mistreatment again.
I learned about Marc Kiefer after first hearing numerous other eyewitness accounts from patients’ rights advocates of abuse and medical neglect at East Bay Hospital. My research turned up an extensively documented report entitled An Inquiry Into the Death of Marc Kiefer at East Bay Hospital, compiled by Protection and Advocacy, an agency mandated by state and federal law to investigate reports of patients’ rights violations in psychiatric institutions.
The report documented how Kiefer was restrained to a bed with leather straps, belts and cuffs for nearly 18 hours, ignored by East Bay’s negligent staff even as he suffered and died all alone in an isolation room, his body covered with bruises from his agonizing ordeal. The report concluded that Kiefer died from the “undiagnosed and untreated” condition of “toxicity from psychiatric medications as well as a prolonged period of improperly monitored seclusion and restraint.”
Marc Kiefer had successfully coped with mental disability for nearly 20 years, building a full, independent life with close family and friends. He played semi-pro baseball after high school, graduated from the University of California at Berkeley and earned teaching credentials at Cal State in Hayward. He was a sports writer for the Alameda Newspaper Group.
At the conclusion of Street Spirit’s first investigative article on East Bay’s scandalous conditions (“One Death Too Many at East Bay Hospital”), I wrote about Marc Kiefer’s death:
“When he was sent to East Bay Hospital, it was the first time in his life that he had ever been on a locked psychiatric unit for in-patient care. It was also the last time. That one referral ended his life. That’s the lesson here, county mental health directors. Even one more referral may be one referral too many.
“End the referrals to East Bay Hospital now.”
Indictment of county officials
The referrals have now ended. The deaths have been stopped. The patients who were once sent to this nightmarish institution will be sent elsewhere. But why did it take the deaths of Robert Jackson, Nancy Jane Turner, Edward Emmerson, Marc Kiefer, and the permanent crippling of Sharon F. to finally end the intolerable abuses at East Bay? And what of the county officials responsible for sending their most vulnerable, disabled residents there for more than a decade? What do they plan to say to alleviate the suffering of families whose loved ones were mistreated for so long?
They plan to say nothing at all. Not an apology, not an explanation, not a word of comfort. In the 15 months that Street Spirit and patients’ advocates have been pushing county officials to close East Bay Hospital, they have continued to exhibit, with very few exceptions, the same callous disregard for patients and their families that led them to send people to a substandard hellhole to begin with.
It is an indictment of the mental-health system that these abuses were allowed to fester for so long in a forgotten corner of Richmond. County supervisors and mental health directors who were supposed to safeguard the rights of the poorest, most disabled clients utterly failed to do so. Officials from Alameda, Contra Costa, Santa Clara, Marin, Lake, Napa, Solano and other counties who referred their residents to East Bay are morally and legally responsible for endangering lives for 14 years. These officials continued to send Medi-Cal patients to East Bay despite all the dangers signs, in callous disregard of the heartrending reports of abuse from psychiatric clients and their families, and an endless trail of alarming reports by the State Health Department’s Licensing Division, the Office of Patients Rights, Protection and Advocacy and local patients-right groups.
County mental health directors serve people who are voiceless and powerless — people who didn’t have a choice when they were sentenced to dwell in the insufferable conditions at East Bay Hospital.
Betraying the public trust
The counties had the authority to halt referrals, but for too many years failed to do so. When they finally responded to the outcry from Street Spirit and patients’ rights groups and began ending referrals to East Bay, they covered up their reasons for doing so in unseemly acts of bureaucratic cowardice that once again betrayed the public interest. Rather than finally telling mental-health clients and their families that East Bay had a disturbing history of patients’ rights violations, county officials caved in to their fears of being sued by the hospital’s legal team, and refused to tell the public the truth.
Some county officials acknowledged off the record that they had been forced to halt referrals to East Bay after literally dozens of investigations (triggered by our campaign against the facility) revealed highly inadequate conditions. Yet, so afraid were county officials of being sued by East Bay for harming a private business, that they never did come clean and warn the unsuspecting public of the conditions of neglect and mistreatment that led them to suspend referrals. To the bitter end, even as East Bay was closing its doors, county mental health directors violated the public’s right to know about conditions in publicly funded hospitals, and prevented families from protecting their members who were sent to East Bay.
This breakdown of accountability by the mental health directors and boards of supervisors — especially of Alameda, Contra Costa, Marin and Santa Clara Counties — is an unacceptable dereliction of duty. Mental health clients and their families deserved protection, but instead were endangered. The public deserved truth, but received only evasions and silence from county officials whose only concern was to avoid honestly acknowledging their own mistakes.
People of Conscience
East Bay could never have been closed without the selfless courage of people of conscience who spoke out no matter the personal cost. First and foremost, patients’ rights advocates from Mental Health Consumer Concerns (MHCC) worked tirelessly to safeguard the rights and well-being of clients at East Bay Hospital. Even though the bullying administrators at East Bay intimidated and attacked them on both personal and professional levels, these advocates never wavered in fearlessly defending the rights of their clients.
MHCC advocates accused of being the sources for Street Spirit’s articles were forced to undergo a grinding interrogation ordered by former Contra Costa County Mental Health Director Lorna Bastian, and were threatened with termination if they refused. East Bay Administrator Lois Patsey tried to retaliate against MHCC by asking county and state officials to launch punitive investigations to silence the advocates.
The public owes an immense debt to the dedication of MHCC advocates who risked their jobs repeatedly to speak out against psychiatric abuses. MHCC advocates also blew the whistle when East Bay tried to open a geriatric ward to bail out of its financial difficulties last winter, and influenced State Licensing to stop the hospital in its tracks.
The Network Against Psychiatric Assault (NAPA), a Berkeley-based human rights group, organized a valiant protest at the very doors of East Bay Hospital last summer, spoke out at public hearings on the hospital’s abuses, and lobbied county officials. Ted Chabasinski of NAPA was a tireless campaigner to abolish the hospital’s mistreatment of its clients. Upon learning of East Bay’s closure, Chabasinski said: “We closed one of the worst institutions in the Bay Area, and this will improve the living conditions of all those who would have been sent there. It’s true that many people thought we couldn’t close East Bay, and I don’t know of any hospital that’s ever been closed like this as a direct result of protest. Here we set our sights on closing this hospital and I think it’s a tremendous victory for the movement.” NAPA’s protests and organizing gave a strong voice to the psychiatric survivors themselves.
Investigators and attorneys from Protection and Advocacy, Inc. and the State Office of Patients’ Rights were indispensable in carefully documenting the appalling conditions at East Bay. Their painstakingly researched investigations and reports were an invaluable resource to the public, and helped enormously in documenting the hospital’s distressing history. East Bay’s Lois Patsey struck back by trying to force the State Mental Health Department to terminate Protection and Advocacy’s contract, but failed to silence the agency.
Several people of conscience who worked at East Bay spoke out against conditions there. Many to this day are afraid to be identified, but they played a vital role in documenting conditions from within. Sue Britt, formerly a Registered Nurse at East Bay, conscientiously spoke out publicly against the hospital’s mistreatment of its patients and its substandard medical conditions. Britt’s was willing to be a public whistle-blower when so many never found the courage; her conscience redeems one’s faith in the medical profession.
Two heartening exceptions to an otherwise dismal rule of bureaucratic cowardice are Alane Friedrich, chair of the Alameda County Mental Health Board, and Donna Wigand, mental health director of Contra Costa County. Friedrich and other mental-health board members had the integrity to recommend an end to all involuntary referrals to the hospital, and the guts to stand up to Mental Health Director Marye Thomas, who was responsible for condemning Alameda County residents to East Bay for years. Wigand finally became the first mental health director to publicly recommend that the Contra Costa County Supervisors suspend all referrals because of substandard quality of care. Since Contra Costa was East Bay’s host county, her recommendation carried great weight, and influenced other counties to withdraw.
Finally, the families of Marc Kiefer, Robert Jackson, Nancy Turner, Edward Emmerson, and Sharon F. displayed the most heart of all. The families of Kiefer and Jackson sued and exposed East Bay after the deaths of their loved ones. Nancy Turner’s sister, Edward Emmerson’s partner, and Sharon and her husband spoke out boldly about the tragic suffering and deaths of their family members.
An unjust death is the hardest loss to bear. Martin Luther King, Jr. said that the unearned suffering of the innocent is redemptive. That is a very hard teaching, but a deeply true one. More than any other factor, the undeserved suffering of these families challenged all of us in the patients’ rights movement to shut East Bay Hospital down so this anguish would never visit another family. We offer these families our deepest sorrow over the loss of their loved ones. We owe them our promise to never forget, and to never let it happen again.
Terry Messman was a longtime anti-war activist and homeless rights advocate who co-founded Street Spirit in March 1995. He was Editor in Chief of Street Spirit for 23 years.